Department of Psychology, University of Oslo, Oslo, Norway.
Norwegian Institute of Public Health, Oslo, Norway.
Int J Epidemiol. 2018 Feb 1;47(1):156-165. doi: 10.1093/ije/dyx186.
Prenatal exposure to maternal anxiety has been associated with child emotional difficulties in a number of epidemiological studies. One key concern, however, is that this link is vulnerable to confounding by pleiotropic genes or environmental family factors.
Data on 82 383 mothers and children from the population-based Mother and Child Cohort Study and data on 21 980 siblings were used in this study. Mothers filled out questionnaires for each unique pregnancy, for infant difficulties at 6 months and for emotional difficulties at 36 months. The link between prenatal maternal anxiety and child difficulties were examined using logistic regression analyses and multiple linear regression analyses for the full study sample and the sibling sample.
In the conventional full-cohort analyses, prenatal exposure to maternal anxiety was associated with child difficulties at both 6 months [odds ratio (OR) = 2.1 (1.94-2.27)] and 36 months [OR = 2.72 (2.47-2.99)]. The findings were essentially the same whether we examined difficulties at 6 months or at 36 months. However, these associations were no longer present once we controlled for potential social and genetic confounders in the sibling comparison analyses, either at 6 months [OR = 1.32 (0.91-1.90)] or at 36 months [OR = 1.28 (0.63-2.60)]. Findings from multiple regression analyses with continuous measures were essentially the same.
Our finding lends little support for there being an independent prenatal effect on child emotional difficulties; rather, our findings suggest that the link between prenatal maternal anxiety and child difficulties could be confounded by pleiotropic genes or environmental family factors.
多项流行病学研究表明，孕妇焦虑会对儿童的情绪问题产生影响。然而，一个关键问题是，这种关联可能容易受到多效基因或环境家庭因素的混杂。
本研究使用了基于人群的母婴队列研究中的 82383 名母亲和儿童的数据以及 21980 名兄弟姐妹的数据。母亲们在每个独特的孕期、婴儿 6 个月大时和 36 个月大时填写问卷，评估婴儿的困难程度和情绪问题。使用逻辑回归分析和多元线性回归分析，对全队列样本和兄弟姐妹样本进行了分析，以检验产前母亲焦虑与儿童困难之间的关系。
在常规的全队列分析中，产前母亲焦虑与儿童在 6 个月[比值比（OR）=2.1（1.94-2.27）]和 36 个月[OR=2.72（2.47-2.99）]时的困难有关。无论是在 6 个月还是 36 个月时评估困难，结果基本相同。然而，一旦我们在兄弟姐妹比较分析中控制了潜在的社会和遗传混杂因素，这些关联在 6 个月时就不再存在[OR=1.32（0.91-1.90）]或在 36 个月时[OR=1.28（0.63-2.60）]。多元回归分析的连续测量结果基本相同。
我们的研究结果几乎没有支持儿童情绪困难存在独立的产前影响；相反，我们的研究结果表明，产前母亲焦虑与儿童困难之间的联系可能受到多效基因或环境家庭因素的混杂。
